PROXY FORM
ANNUAL GENERAL MEETING
(Please see notes overleaf before completing this Form)
LIPPO MALLS INDONESIA RETAIL TRUST
(Constituted in the Republic of Singapore pursuant to a
Trust Deed dated 8 August 2007)
IMPORTANT:
1.
A relevant intermediary may appoint more than two proxies to attend and
vote at the Annual General Meeting (please see Note 2 for the definition
of “relevant intermediary”).
2.
For investors who have used their CPF monies to buy units in Lippo Malls
Indonesia Retail Trust, this Report is forwarded to them at the request of
the CPF Approved Nominees and is sent
FOR INFORMATION ONLY
.
3.
This Proxy Form is not valid for use by CPF investors and shall be ineffective
for all intents and purposes if used or purported to be used by them.
4. PLEASE READ THE NOTES TO THE PROXY FORM.
Personal data privacy
By submitting an instrument appointing a proxy(ies) and/or representative(s),
the Unitholder accepts and agrees to the personal data privacy terms set
out in the Notice of Annual General Meeting dated 1 April 2016.
I/We,
(Name)
of
(Address)
being a Unitholder/Unitholders of Lippo Malls Indonesia Retail Trust (“
LMIR Trust
”), hereby appoint:
Name
NRIC/Passport No.
Proportion of Unitholdings
No. of Units
%
Address
and/or (delete as appropriate)
Name
NRIC/Passport No.
Proportion of Unitholdings
No. of Units
%
Address
or failing the person, or either or both of the persons, referred to above, the Chairman of the Meeting as my/our proxy/
proxies to attend and vote for me/us onmy/our behalf at the Seventh Annual General Meeting (the “
Meeting
”) of Unitholders
of LMIR Trust to be held at Mandarin Ballroom 1, Level 6, Main Tower, Mandarin Orchard Singapore, 333 Orchard Road,
Singapore 238867 on Friday, 22 April 2016 at 2:00 p.m. and at any adjournment thereof. I/We direct my/our proxy/proxies
to vote for or against the Resolutions proposed at the Meeting as indicated hereunder. If no specific direction as to voting is
given or in the event of any other matter arising at the Meeting and at any adjournment thereof, the proxy/proxies will vote
or abstain from voting at his/her discretion.
No. Ordinary Resolutions
No. of votes
‘For’*
No. of votes
‘Against’*
Ordinary Business
1 To receive and adopt the Report of the Trustee, the Statement by the Manager,
the Audited Financial Statements of LMIR Trust for the financial year ended
31 December 2015 and the Auditors’ Report thereon
2 To re-appoint RSM Chio Lim LLP as Auditors of LMIR Trust and authorise the
Manager to fix the Auditors’ remuneration
Special Business
3 To authorise the Manager to issue new Units and to make or grant convertible
instruments
*
If you wish to exercise all your votes ‘For’ or ‘Against’, please tick (√) within the box provided. Alternatively, please indicate the
number of votes as appropriate.
Dated this
day of
2016
Total number of Units in:
No. of Units
(a) CDP Register
Signature of Unitholder(s)/ Common Seal of Corporate Unitholder
(b) Register of Unitholders
IMPORTANT: PLEASE READ NOTES TO PROXY FORM ON REVERSE PAGE
